Cancer Center Therapeutic Pre Cert Counselor- Chemotherapy Suite - Union Square- Full Time Days

Job description

The Cancer Center/Therapeutic pre-certification counselor is responsible for insurance verification, obtaining authorization for all services, and calculation and patient notification of co-insurance, co-payments and deductible for all treatment plans and services provided for patients of the Cancer Center and Therapeutic Programs 1.Determines and verifies patient demographic and insurance information and updates all requires systems to ensure all have correct information. 2.Identifies hospital visits/services which require a referral and obtains the required referral from provider 3.Obtains authorization for all services, procedures, and treatments being provided in the Centers, prior to the requested treatment start date. Authorizations are to be obtained online via the payer/vendor web portal when available or via phone /fax. 4.As part of the authorization process, verifies medical necessity of the CPT/HCPCS codes being ordered via the CMS or payer web site, or via the drug website. Off-label treatments need to be identified prior to treatment being started 5.When required, reaches out to the clinical team to obtain a letter of medical necessity which might be required to obtain...